Coalition Efforts Are Paying Off!

The Florida Coalition for Optimal Mental Health and Aging was formed in 1998 as a statewide coalition of service providers, policy makers, academicians, agency directors, and many others, to improve the availability and quality of mental health and substance abuse services for older Floridians and their families. Thanks to the work of its members who volunteer their time, the Coalition has influenced Florida's policy. Coalition efforts are paying off. Coalition members have been involved in the following:

• Based on legislative drafts by the Coalition, the 2000 Florida legislature passed a law requiring the Florida Dept. of Children and Families (DCF) to identify older persons with mental illness and/or substance abuse disorders as specific target populations for state funding.
• A statewide task force was formed to define target populations and establish performance indicators for each elderly group. Thus far, the Task Force has defined seven target populations that are currently being integrated into the state data system.
• In the 1999 legislation establishing the Florida Commission on Mental Health and Substance Abuse, the Coalition was instrumental in inserting language requiring the Commission to address issues relating to older persons. Dr. Larry Dupree, Co-Chair of the Coalition, also chaired the Older Adult Work Group for the Commission. The Older Adult Work Group report became part of the Commission's final report, providing recommendations for prevention, outreach, identification, access, quality care, outcome evaluation, staff training, and funding. The Commission's report was sent to the Governor and State Legislature earlier this year.
• The Coalition's advocacy has resulted in a contract of $50,000 for substance abuse prevention services with an aging provider in Broward County. An additional $85,000 contract is being finalized with the same provider for substance abuse and aftercare services. Also, it has resulted in special tracks in detoxification, day treatment, and residential services; and sensitized administrators to think about older adult programming. Additional funding for statewide sites is also being considered.
• The Coalition has an annual statewide conference with national and local presenters emphasizing education and advocacy. During the annual October conferences and throughout the year, work groups conduct Coalition business, working hard to improve services for older Floridians. Work groups focus on legislation/policy, long term care services, community-based care, information and training, Coalition membership, and finances of the Coalition. Regional and local presentations, as well as presentations during other organization's meetings are numerous.
• The Coalition acts as a clearinghouse resource regarding elder mental health and substance abuse issues. Our newsletters are distributed statewide to over 700 individuals (306 members, 190 individuals requesting to be on our "Keep Me Informed" list, as well as others that we think should also be informed). The Coalition web page has drawn a lot of attention, and generated numerous and diverse requests (from requests for information to requests for referral and placement recommendations to collaboration with other organizations).
• Coalition efforts at educating the public, as well as paid service providers, about elder mental health and substance abuse issues include establishment of a speakers' bureau (experts willing to volunteer their time to talk to various groups), newsletters, and local or regional conferences and training events.
• In partnership with Florida Medical Quality Assurance Inc., 15,000 "posters" on depression in older adults are being mailed to primary care physicians in Florida, to alert both physicians and patients of the signs and symptoms of depression.
• The Co-Chairs were invited to attend national meetings of coalitions to describe the success of the Florida Coalition for Optimal Mental Health and Aging, and asked to help in developing and hosting a national web site on mental health and aging coalitions.

The Coalition holds its annual conference each October, bringing together individuals and organizations from around the state, as well as national leaders in aging, mental health, and substance abuse issues. Last year's conference was a great success, and this year's promises to be even better. Join us for the October 25-26 conference in Tampa. Together we can improve mental health and substance abuse access and services for older Floridians and their families.

Work Group Reports

Coalition Legislative Work Group Report
By Ken Sarvis, Mental Health Associations in Florida, Inc.

In terms of the state budget, this was an unusual year at the Florida Legislature. Though the state economy slowed somewhat, state revenue increased by about 4.6%, and is expected to maintain this healthy growth rate.

Nevertheless, policymakers set a goal of reducing state expenditures by 4.0%. Part of the reason for this reduction was the Governor's priority of providing a tax cut in the range of $350 million. Another factor was the projected increase of approximately $944 million in the Medicaid Program. Actually, the state's proportional share of the projected Medicaid cost increase was in the range of $405 million, with the federal match covering the remainder. Even so policymakers used, with the press and human services' advocates, the almost one billion dollar Medicaid figure, the need for a tax cut, and "slowing economic growth" as grounds for reducing expenditures in health and human services.

Funding of Health and Human Services (HHS) represents 34.4% of the state budget, or $16.47 billion. The mental health portion of the HHS budget is $628 million, or 3.8%.

Last year the state began the transition to community-based care with the planned closing of G. Pierce Wood State Mental Health Hospital. To enable individuals with mental illnesses to "transition" from institutional care to life in their own communities, the largest proportion of new funding for mental health, $39 million, focuses on the G. Pierce Wood catchment area.

Of the $39 million, $8.75 million is reserved until February 1, 2002 to ascertain the need for these funds for the GPW conversion. If not needed, these funds or a portion of these funds will be made available to fund community-based programs in other parts of the state.

The $39 million is distributed as follows: (in millions)

$1.3 - Indigent Drug Program $8.2 - Adults in Crises CSU Beds $12.8 - ACT Teams Annualization & Enhancements $3.0 - GPW Clinical & Case Management Teams $13.6 - Adult Mental Health Redesign Other, non-GPW, funding includes: $0.47 - District 4 Choice-based Pilot Project $5.0 - Homelessness Coalitions $1.9 - Increase Forensic Bed Capacity by 30 Beds $5.0 - Increase Indigent Drug Program (Institution) $1.0 - Increase Indigent Drug Program (Community)

Footnote: As a result of the Coalition's success last year in establishing in law a target group definition for the elderly in need of mental health and substance abuse services, the Department of Children and Family Services submitted a budget request of $2.8 million for service to the severe and persistently mentally ill elderly. This is the first budget request in perhaps a decade directed specifically at the elderly with mental health or substance abuse problems. Unfortunately, the Governor did not approve this request and, therefore, did not submit it as part of his budget proposal to the Legislature.

The Work Group for Information and Training
By Betty Watson

The WIT Work Group has held two meetings this year, 1/11 and 4/12/01. Our goals are to continue to work on: (1) the Speakers Bureau, developed by Dr. Charles Boardman, (2) two regional workshops for professionals and paraprofessionals; the first to be scheduled in Ft. Lauderdale on the topic of Substance Abuse in the Elderly, presented by Drs. Larry Dupree, Marion Becker and Larry Schonfeld, (3) the FL Coalition Newsletter; Suzy Lange has been working with Lisa West, Director of Training, Dept. of Aging and Mental Health, de la Parte Institute, USF, (4) media and community resources; Dawn Weston is heading up a sub-committee to identify existing resources to be used for education, training and public awareness of mental health and substance abuse issues related to the older adults, and (5) networking with other community organizations.

The next meeting of the Work Group for Information and Training will be held on July 12, 2001.

Community Services/Treatment Work Group

The goal for the Community Services/Treatment Work Group is to increase the effectiveness of the primary care physician's (PCP) practice in relation to depression.

Objectives:
1. Identify and promote effective strategies for implementation that assist the PCP in recognizing, screening, and diagnosing depression. These strategies will include components that support and enhance the PCP/Patient interaction.
2. Identify and promote effective models of treatment for behavioral health providers.
3. Identify and promote effective strategies for implementation that assist the PCP in following up with patients who have been clinically diagnosed with depression.

Long-Term Care Services & Treatment Work Group

The Long-Term Care Work Group met most recently in April and focused on their top 2001 priority: affordable training for the long-term care system. The group reviewed and identified a number of immediately available instruments to assist in training long-term care staff members.

Some of the items identified and discussed in the meeting report included a training manual developed for in-house application; a ten-tape videotape series of instructional presentations on caring for Alzheimer's patients; Grace Daley's personally produced video, Circle of Addiction; the ongoing need for Baker Act training and inclusion in the report of a useful handout on that subject; specific library and web site resources; and the FCOMHA Speaker's Bureau, now being finalized.

New Florida Law Helps Medicare Beneficiaries

If you are a Medicare beneficiary residing in Florida, you can receive prescriptions at a potential savings from retail prices. A new law designed to help Medicare beneficiaries who pay for the entire cost of prescriptions went into effect July 1, 2000.

How does the program work? Simply take your prescription along with your Medicare card to a pharmacy that accepts Medicaid. You will receive that prescription at a cost no greater than the average wholesale price minus 9% plus a $4.50 dispensing fee. You do not have to be a Medicaid recipient.

Any Florida resident with a Medicare card is eligible to participate. You do not have to fill out any forms, no prior authorization is required and all prescriptions are covered. The only requirement is that you go to a pharmacy that participates in Medicaid.

You may want to use that program if your insurance does not cover a certain drug, or if you have reached the prescription limit or have a deductible to meet under your current insurance plan.

For questions about the program, call the Medicaid Bureau of Pharmacy Service at 1–850–487–4441. For Medicare rights or quality of care questions, call Florida Medical Quality Assurance, the Medicare Peer Review Organization in Florida, at 1–800–844–0795.

Upcoming Events!

4th Annual Conference
"Facing the Future"

October 25th and 26th, 2001
UP TO 12.5 CECs

The Conference will be located at the:
TRAVELODGE
"Under New Management"
820 E. Busch Blvd.
Tampa, FL 33612
(813) 933-4011 phone
(813) 932-1784 fax

For More Information Contact:
Jini M. Hanjian, Ph.D.
hanjian@fmhi.usf.edu
Phone: (813) 974-5929

Available Services

Speakers Bureau

The Speakers Bureau can provide presenters for the following topics within some geographic areas of the state. If your organization or group wishes a speaker on one of these topics, please contact Betty Watson, (813) 974–1975.

Copyright © 2001 by the Florida Coalition for Optimal Mental Health and Aging